儿童红细胞悬液输注不良反应分析及护理

The analysis of adverse reactions in red blood cell suspension transfusion and nursing

目的 探讨儿童血液科患儿输注红细胞悬液发生不良反应的相关因素,提高输血患儿的安全性以及护士对输血风险的防范能力。方法 对本科2010年1月～2013年8月输注红细胞悬液的住院患儿的病历进行统计分析。结果 第1次输注红细胞悬液者929人,第2次及以上输注红细胞悬液者747人,共计3 478例次,发生输血反应30例,输血反应发生率为0.86%,其中非溶血性发热反应17例（56.67%）,过敏反应13例（43.33%）。第1次输注红细胞悬液者输血反应6例（0.97%）,第2次及以上输注红细胞悬液者输血反应24例（0.32%）。第2次及以上输注红细胞悬液者与第1次输注红细胞悬液者比较,输血不良反应发生率差异具有统计学意义（P〈0.05）。结论 儿童血液科患儿输注红细胞悬液不良反应表现为非溶血性发热和过敏反应;输血不良反应的发生与输血次数有关。

Objective To explore the adverse effects associated with transfusions of red blood cell （RBC） suspension in pediatric patients with hematologic diseases and to improve the safety of blood transfusions in children and the nurses＇ capability on risk prevention during RBC transfusions. Methods Hospitalized patients treated in our department were analyzed from January 2010 to August 2013. Results 929 patients received rod cell suspension transfusion once and 747 patients received transfusion twice,of which 30 patients demonstrated reactions associated with blood transfusion, accounting for 0.86% in all patients receiving transfusions. Among these patients, 17 presented febrile non-hemolytic transfusion reactions and accounted for 56.76% ; 13 presented allergic reactions and accounted for 43.33%. Six patients developed transfusion reactions in patients after receiving transfusion once, compared with 24 patients who developed transfusion reactions after receiving transfusions twice. There were significant differences between these two groups （ P 〈 0. 005 ）. Conclusion The adverse effects of transfusion reaction in children consisted mainly of febrile non-hemolytic transfusion reaction and allergic reactions. Transfusion reaction was correlated with the number of transfusion received.